A case of adult-onset dementia with argyrophilic grains

A case of progressive dementia in a 68-year-old woman was characterized by the postmortem finding of widespread argyrophilic grains in the cerebral cortex. The grains consisted of 10- to 13-nm filaments in deposits ranging up to 9 microns in length and 3 microns in diameter. The grains stained positive with Alz-50 monoclonal antibody. Cortical brain tissue levels were minimally elevated for acetylcholinesterase, moderately reduced for choline acetyltransferase, and sharply reduced for glutaminase. Although the case was clinically indistinguishable from Alzheimer's disease, plaque and tangle pathological findings were absent. We confirm cortical changes of the type described by Braak and Braak and provide additional data on subcortical changes in this case.